Please mark the box that describes your current practice.
NUTRITION: Feeding Practices
Already doing
Making progress
in doing
Planning
to do
Not planning
to do
1. Parents receive written nutrition policies
upon enrollment.
2. Parents are informed about what their
children are eating.
3. If food is brought from home, parents
are provided with guidelines.
4. Menus are posted for parents to see.
5. Meals and snacks are scheduled at
regular times.
6. Portion sizes are age appropriate.
7. Mealtimes are relaxed, calm and with
shared conversation.
8. Children decide which foods they will
eat from the foods oered.
9. Children are not required to eat all the
food on their plates.
10. Children serve themselves from serving
dishes at mealtime.
11. Children with special needs have their
nutrition needs taken into account.
12. Food is served in a form that young
children can eat with minimum
assistance and without choking.
13. Adults sit with children at mealtime.
14. Adults eat the same foods as children
at mealtime.
15. Foods are served that reect the
ethnicity and cultures of all children in
the center/home.
16. Special occasions and holidays are
celebrated with mostly healthy foods or
with non-food treats.
17. Parents are provided a supportive
breastfeeding environment.
18. Water is freely available both indoors
and outdoors.
AUG 2010
Self-Assessment Questionnaire
NAME ___________________________________________________ DATE
NUTRITION: Food Served
19. 100% fruit juice is oered:
1 time per day 2 times per day 3–4 times per day Never
20. Chicken nuggets, sh sticks, hot dogs,
corn dogs, bologna or other lunch meat,
sausage or bacon are oered:
1 time per week 2 times per week
3 or more times
per week
Never
21. Whole grain bread, oatmeal, whole
grain cereal, brown rice, whole wheat
tortillas, corn tortillas or other whole
grains are oered:
1 time per day 2 times per day 3 times per day Never
22. Vegetables including fresh, frozen or
canned, are served:
1 time per day 2 times per day 3 times per day Never
23. Fruit, including fresh, canned in water or
own juice, frozen or dried is served:
1 time per day 2 times per day 3 times per day Never
24. Milk served to children ages 2 years
and older is:
whole or regular 2% reduced fat 1% reduced fat skim or non-fat
PHYSICAL ACTIVITY
Already doing
Making progress
in doing
Planning
to do
Not planning
to do
25. Parents receive written physical activity
policy upon enrollment.
26. Daily play and planned movement
experiences both indoors and outdoors
are provided to children.
27. Information is provided to parents about
their children’s physical activity choices
while in child care.
28. Sta participate in physical activities
with children.
29. Restriction of play time is not used as a
disciplinary tool.
30. Activities, equipment and outside play
areas are developmentally appropriate
and safe.
31. Media time for children is used only for
educational purposes.
STAFF AND PARENT TRAINING
Already doing
Making progress
in doing
Planning
to do
Not planning
to do
32. Training opportunities are provided for
sta on physical activity for children.
33. Training opportunities are provided for
sta on child nutrition.
34. Parents are provided information that
encourages physical activity at home.
35. Parents are provided information on
child nutrition and healthy eating.
AUG 2010
The project was made possible in part by a grant from the Vitamin Cases Consumer Settlement Fund. Created as a result of an
antitrust class action, one of the purposes of the Fund is to improve the health and nutrition of California consumers.
This material was partially funded by the California Department of Public Health, Network for a Healthy California, USDA Supple-
mental Nutrition Assistance Program (formerly the Food Stamp Program). These institutions are equal opportunity providers and
employers. In California, food stamps provide assistance to low-income households and can help buy nutritious foods for better
health. For food stamp information, call 877-847-3663. For important nutrition information, visit www.cachampionsforchange.net.
